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Here's my newest venture .... :-)
In response to lots of questions about joint injections and the issues that surround them I've decided to set up a separate site devoted to this topic.
This site is all about shoulder pain and how to treat it but I wanted a place where I could provide information about injection treatments for problems elsewhere in the body. I'll also explore the issues around new types of arthritis treatment and other topics on related subjects.
Take a look and leave a comment - here's the link to the new
joint injections site.
Labels: joint injection, joint injections, website about joint injections
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Orthopaedic medicine is the area of medical practice that deals with joint pain, muscle pain and bone pain ... but from a non surgical perspective
An
orthopaedic medicine specialist will assess your pain problems and provide treatment using injections, manipulations, acupuncture or other similar therapy
Most orthopaedic medicine doctors are not surgeons but they usually work closely with surgical colleagues to make sure that your care is optimised
Doctor Gordon Cameron is an orthopaedic medicine specialist based in Edinburgh, Scotland
Labels: medical orthopaedics, orthopaedic medicine, orthopaedic sports medicine, orthopedic medicine, orthopedic sports medicine, specialist in orthopaedic medicine
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I get a lot of email questions about shoulder hydrodilation treatment for frozen shoulder
Some people call it shoulder hydrodistension or
hydrodilatation. Medical journals sometimes refer to it as a "therapeutic arthrogram" - but it all amounts to the same thing ... using warm saline to stretch out and distend the shoulder joint capsule
The joint capsule is the bag of gristle that surrounds the shoulder. In a frozen shoulder it becomes inflamed and sticky - sticking to itself and to other parts of the joint too. Injecting warm salty water under mild pressure helps to break up the stick adhesions and frees the joint to a more normal range of painfree movement
I'm pleased to say that
frozen shoulder hydrodilatation treatment is now available in Edinburgh. It works well for frozen shoulder pain at all stages but is particularly good for those whose pain is very severe or who have a shoulder that is very, very stuck
Labels: distension arthrogram, frozen shoulder distension, frozen shoulder hydrodistension, hydrodilatation of the shoulder, shoulder hydrodilation
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I've been interested to read some recent research about the use of products like
Synvisc One or
Ostenil for the treatment of frozen shoulder.
These
viscosupplementation treatments are more often thought of in terms of osteoarthritis - particularly in the knee - but recent developments have seen some doctors claim good results when used along with steroid injections (or instead of steroid injections) for shoulder pain treatment.
I'd like to hear your views.
Have you had shoulder pain treated using viscosupplementation - this might include Synvisc, Synvisc One, Supartz, Ostenil, Euflexxa, Durolane or other similar products.
Leave me a comment and let me know - I'd like to hear of your experiences.
Labels: frozen shoulder ostenil, frozen shoulder supartz, ostenil injections, supartz injections, synopsis injection, synopsis injections, synvisc one injections, viscosupplementation for shoulder pain
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Pain behind the knee is a common symptom and can be associated with a number of different underlying conditions.
In older people pain at the back of the knee may be a symptom of osteoarthritis or wear and tear. In athletes this symptom can indicate a cartilage tear or sometimes it might point to damage in the anterior or posterior cruciate ligament.
Bakers Cyst is another
frequent cause of a pain behind the knee - the joint capsule fills up with fluid and the posterior area bulges out causing a visible and painful swelling.
If you develop pain at the back of your knee then seek help early and get some investigations and treatment sorted out as soon as you can.
Labels: anatomy behind the knee, arthritis, bakers cyst knee pain, muscle pain behind the knee, severe pain behind the knee
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Sports Injury Clinics
One of the great benefits from using
Sports Injury Clinics for assessment and treatment of your joint or muscle pain is that you can expect to get input at a high level from doctors and physical therapists with years of experience in dealing with athletes
Your pain or sporting injury will be carefully assessed, investigated using x-rays or ultrasound or MRI scanning and then an individual plan for treatment and rehab will be worked out
Doctor Cameron has turned his years of experience as an
orthopaedic specialist to good use in treating football or soccer related injury - along with other sports injuries such as
jumpers knee.
Most clinics specializing in sports injury operate a team of professionals who work together and provide a comprehensive rehabilitation service for those involved in sport.
Labels: arthritis doctors, musculoskeletal injuries, sports injury clinics, sports injury clinics scotland, sports medicine doctors, sports physiotherapist
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Doctor Cameron has now made his years of experience of treating sports injury in professional sportsmen and athletes available to all - and not just those involved in professional sport
For nearly fifteen years he has worked as a team doctor to professional soccer players and has vast experience in assessing injury and planning a clear and rapid road back to recovery
Labels: sporting injury rehab, sports injury scotland, sports injury treatment, sports medicine clinic edinburgh, sports medicine doctor, treatment for a sporting injury, treatment for sporting injury
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I'm often asked about whether
Hyalgan can be used to treat shoulder pain in the same way that it works for arthritis of the knee
Hyalgan is a useful treatment for knee pain in general - but works particularly well for osteoarthritis of the knee. It's given by injection - sometimes on only one occasion or sometimes repeatedly over the course of two or three weeks
Shoulder Doctor, Gordon Cameron now offers a comprehensive Hyalgan, Supartz, Orthovisc and Synvisc Treatment service. If you have chronic knee pain then these options might make a huge difference. Consultations and treatments are available in Edinburgh, Scotland
You can make an appointment to
discuss treatments and options here.
Labels: euflexxa, hyalgan, hyalgan injection, hyalgan injections, ostenil, sinvisc, supartz, supartz injection, supartz injections, suplasyn, synvis synvics, synvisc
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If you are based in the UK and are looking for a specialist
shoulder clinic then look no further.
Doctor Cameron is delighted to announce that he can now provide a top level expert shoulder pain service.
Based in the cutting edge Edinburgh Clinic, you can now consult with Doctor Cameron and find help for your shoulder pain problems. You'll find on site facilities for x-ray, for ultrasound scanning of the shoulder, for CT and MRI and for guided injections.
Hydrostension treatment or therapeutic arthrogram is now available for severe or persistent frozen shoulder pain.
Click here for more details of how to make an appointment with
Shoulder Dr Cameron at his specialist
Edinburgh Shoulder ClinicLabels: consult shoulder doctor, hand shoulder, shoulder clinic scotland, shoulder dr, shoulder specialist edinburgh, sports medicine specialist scotland
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Shoulder Specialist
A message from Doctor Cameron:
I'm delighted to say that I am now able to offer a high level
Shoulder Specialist service to those who would like to consult with me directly.
Based in
the Edinburgh Clinic - a new private medical clinic in central Edinburgh, I can now offer the kind of comprehensive servide you would expect from a specialist
shoulder doctor.
I can offer detailed personal consultations, with instant access to MRI or ultrasound scanning. The clinic can also provide hydrodistension treatment for frozen shoulder, x-ray or ultrasound guided injections, nerve blocks and a range of other cutting edge treatments.
Click for details of how to make an appointment for an orthopaedic specialist opinion
Labels: musculoskeletal specialist, orthopaedic specialist, shoulder dr, shoulder specialist edinburgh, shoulder specialist scotland, shoulder specialists
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There are lots of ways to
treat frozen shoulder - lots and lots and lots. And that's the problem for many people.
If you have a frozen shoulder then how do you even begin to decide which treatment might work for you?
Should you have physical therapy? If so, from who, how often and at what stage in your frozen shoulder pathway?
Maybe medication would help? But what kind and how often?
Perhaps you need an injection? But what about side effects .... and will it work?
As a frozen shoulder expert I know that thousands of people waste thousands of dollars or pounds each year on shoulder pain treatments that simply don't work for them - or may even make them worse.
But how do you choose?
Well - I've tried to answer that by creating my new Heal Smart method for frozen shoulder treatment. Stage one is a detailed ebook and a series of expert reports. Stage two is a great package of ongoing suppport.
Learning to Heal Smart will get your frozen shoulder better more quickly, more efficiently and at less cost to you.
Click here right now for more details.
Labels: best frozen shoulder treatment, treat frozen shoulder, what treatment shoulder pain
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Wii Shoulder - Wii Sports InjuryWell, here we are at yet another new frontier post for this intrepid shoulder doc! I'm about to take a big jump into "virtuality." Going to reinvent myself as a little Mii - chasing round after the mii joggers with a little kitbag, popping up in the yoga studio, waving from the audience at the step class - you get the picture.
Been playing Wii sports, Wii Golf, Wii Rockband (axe hero of course) all Christmas and my shoulder is giving me real grief. Quick google search reveals that not only am I not alone .... there are millions of you out there with the same thing.
So - here's the deal. Leave me your comments about any
Wii injuries you've had and I'll pull them together into an article - can't wait to read your stories.
Now - my turn again on Rockband .... Rock, rock, rockaway beach - rock rock rockaway beach ...........
Labels: get rid of shoulder pain, injured by wii sports, nintendo wii injury, wii shoulder, wii shoulder injury, wii sports injury
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The rotator cuff is the group of muscles that surrounds and supports the shoulder as it moves. These are small muscles but incredibly important for day to day function. Problems with the rotator cuff can arise after injury or as a result of overuse or - in older people - because of degeneration changes.
There are lots of options for treating problems in these muscles - ranging from oral pain killers right through to advanced open sugery techniques. But - in my view and it's shared by many shoulder pain experts - the best initial approach to this kind of problem is with
rotator cuff exercises.
You can use these shoulder exercise programs to both give pain relief and to provide strength - thus helping to reduce the risk of the problems coming back again.
You can read more about the rotator cuff and about how to treat problems with it on my page of
expert shoulder reports here.
Labels: exercise for shoulder muscles, rotator cuff exercises, rotator cuff treatment, treat rotator cuff pain
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It's always a bit confusing for a patient if they experience
both neck and shoulder pain at the same time.
Which one is the trigger? Does the neck pain
provoke the shoulder pain or is it the other way around.
I've written lots elsewhere on this site about the issues surrounding referred pain patterns and explained how pain that seems to originate in one part of the body can actually be coming from somewhere else - but how can you begin to sort this out if it's you who has the problem?
Neck pain usually - well, often actually - spreads down to the shoulder and sometimes onwards down the arm. This can arise either due to referred pain from the joints and gristle of the neck - or it can be triggered by a trapped or inflamed cervical nerve root.
Pain spreading from the shoulder upwards to the neck is more unusual - and typically indicates spasm in the trapezius muscle.
Labels: neck and shoulder pain, referred pain neck, trapped nerve in neck
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Should you have an operation on your neck?
Neck surgery is a daunting prospect for many people - and of course with good reason. The tecniques and skills of surgeons have improved hugely in recent years but you can't get away from the fact that the main nerves and arteries of the body run through the neck region.
But some of us do eventually
need a neck operation to relieve pressure on a nerve or to deal with wear and tear in the joints.
In response to frequent prompting I've written a detailed expert report on the subject. Its called
Neck Surgery - Should You Have An Operation On Your Neck - it's available for download now.
I hope you find it helpful.
Labels: cervical spine surgery, neck durgery, operation on neck, surgery trapped nerve, surgical operation for neck pain
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As a doctor with a special interest in
shoulder pain I get asked a lot of questions about steroid injections.
"Will a steroid injection help my shoulder?"
"Is a cortisone shot dangerous?"
"Are steroid injections for the shoulder painful"
I must have answered a thousand emails on the subject over the years, I've given lectures about it and written articles for books and journals. And so .... at last you might say .... I've pulled all that I know together for your benefit. I've been busy crafting a detailed series of expert reports on topics related to neck and shoulder symptoms. One of the most popular is the one about
Steroid Injections for Shoulder Pain.
Take a look - I hope you like it.
Labels: cortisone injection, cortisone shot in shoulder, frozen shoulder, pain after shoulder injection, shoulder injection treatment, steroid injection, steroid injection into the shoulder, steroid shot
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New Expert Reports on shoulder pain topicsAs many of you who read this will know, getting high quality and easy to read information about shoulder pain out there into the world has been a mission of mine for years.
I try very hard to simplify complex topics and to demystify the workings of the body. My various websites relating to
shoulder pain,
blood pressure and other topics have focussed on this approach - and been popular as a result.
Well .... now I plan to take it to the next level. I'm in the process of pulling together a large collection of free
shoulder pain articles - and from there I'll be offering a range of Expert Reports on very specific shoulder pain topics. Quite simply the kind of information you can't get anywhere else online or in print.
Each expert report will be written on a very tight topic but jam packed with detailed information - giving you the next best thing to a one on one session with me.
I hope to launch the first of these reports in the next few days - so
check this page for details.
Labels: consult shoulder doctor, consultation shoulder expert, expert, expert reports, expert shoulder doctor, find a shoulder expert, get rid of shoulder pain, shoulder doctor online
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Can a flu shot cause shoulder pain or other joint pains?
As the festive season approaches it's also the time of year when many millions of us around the world are queuing up for our once a year
flu shot. For most of us the jab passes without incident and with no lasting side effects or problems. But a few are not so lucky.
Over at my
medical questions and answers site we've had a real spate of recent questions asking about whether a
flu jab is painful or not. We've also had a lot of interesting discussion about flu symptoms in general and about
treatment for stomach flu in particular.
Hey - its cold (unless you're reading this in the Southern Hemisphere), we're all depressed about money, coughs and colds are starting and now we're worrying about flu vaccinations!
Happy days !
Labels: flu shot, flu shot problems, flu shots painful, pain after flu jab, shoulder pain after a flu shot, side effects, symptoms after flu shot, treatment for stomach flu symptoms
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Hip pain is a common problem but yesterday I encountered an unusual presentation where a fall causing a shoulder injury was also the trigger for an ongoing painful hip.
One of my patients sustained a bad fall when walking down a flight of steps - landing onto the very tip of the right shoulder. Dislocation seemed like a possibility when the paramedic crew arrived to help out but this was quickly excluded by clinical tests and an x-ray.
The
shoulder pain quickly settled over the following few days but ongoing
hip pain around the upper outer part of the thigh. Bruising appeared and persisted for about ten days and from that time on there was severe tenderness around the prominent bone at the top of the femur.
A specialist in sports injury eventually diagnosed a condition called Trochanteric Bursitis and the lady came my way for injection treatment.
I'm pleased to say that injection into the bursa settled the hip pain within about five days and she has now returned to normal life again. Bursa pain around the hip is common after a heavy fall and often responds well to an injection of steroid.
Youch ..... !
Labels: bursa at hip, bursitis injection, hip injury causing lasting pain, hip pain, pain around thigh and hip, pain in hip area, shoulder injury and hip problems
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I'm delighted to say that my new website devoted to
medical questions and answers has really begun to take off in some style. We now get asked more than fifty questions each day and there's a real sense of community spirit building with some replies coming from me and some from other users of the site.
We've already built a substantial zone devoted to
shoulder pain questions - you should hop over and check it out if you haven't already done so.
Labels: get rid of shoulder pain, medical shoulder, options for pain relief, problems and treatment, shoulder answers, shoulder pain questions
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A Heat Lamp For Shoulder Pain?
I've been suffering from shoulder pain recently.
Yes ... believe it or not it even happens to shoulder pain experts - although I confess it really did take me by surprise. I developed a degree of shoulder bursitis after tweaking my shoulder lifting a case onto an overhead rack on a train.
I'm writing this to let you know that my own discomfort lead me to find a new shoulder pain treatment that I think might help you deal more comfortably with your own shoulder symptoms.
A friend let me borrow a Heat Lamp - an infrared lamp capable of aiming local heat directly into the shoulder tissues and I have to say that it was absolutely wonderful. The soft but penetrating heat just melted my pain away within minutes and I was transformed from a wincing wreck every time I tried to put my coat on to someone with normal painfree function.
After using the heat lamp for my shoulder pain for about a week, the symptoms had gone completely.
I did a bit of research and
Infrared Heat Lamps do seem to be well accepted as part of pain treatment programs.
The emitted heatl lamp energy penetrates up to 3 inches, and stimulates micro circulation, delivering higher levels of oxygen and nutrients to the injured cells, while eliminating toxins and cellular waste. This begins the healing process as pain is relieved.
The FDA and Hundreds of Scientific, Clinical, University and Medical Studies Agree that Far-Infrared Mineral Therapy Relieves Pain.
The best heat lamp for shoulder pain seems to be the New TDP lamp with far infrared mineral technology.
Electronic Healing offer it at a great price and have a reputation for wonderful customer service. They ship worldwide.
Take a
look here for more details of the
TDP Healing Lamp - it certainly worked well for me.
Labels: healing lamp, heat lamp shoulder pain, hot lamp for pain, infra red lamp for pain relief, infrared lamp, infrared lamps, pain lamp, pain relief lamp
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I've found a great new
sleep aid for shoulder pain patients. In my experience many people with shoulder pain have trouble getting off to sleep.
Part of this is due to their pain and to the difficulty in finding a comfortable spot in bed - but part of it relates to the body getting out of its normal sleeping routine. The brain loses its sleep rhythm and dropping off into sleep becomes increasingly difficult.
Well now things are a whole lot easier - and I can vouch for this myself.
The
Nightwave sleep assistant provides a remarkably easy way of getting off into a deep and restful sleep. It produces pulsing waves of a restful blue light and projects the light onto the ceiling of your bedroom. The light is designed to be at the intensity and frequency of the brains natural sleep rhythm ... and boy is it effective.
Electronic Healing are offering the Nightwave sleep assistant at a special price at present - and it comes with a money back promise if you are not happy with it.
Take a look here for more information.
Labels: ask a doctor for advice, can't sleep well, help sleeping, insomnia cure, nightwave, sleep aid, sleep problems
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Online Medical Advice
Online Medical AdviceDr Cameron has created a brand new medical questions and answers website to give you access to high quality medical advice online.
You can post a question on any health topic and get replies either from Doctor Cameron himself or from the wider community.
Take a look - heres the link:
Ask Doctor CameronLabels: ask a doctor for advice, ask doctor, online medical advice
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Pins and needles is the common name for what the medical world call paresthesia. The feeling of tingling in the hands or feet is a symptom of nerve root irritation. This nerve irritation can be due to nerve pressure in the neck or the back - or it can be due to pressure on a nerve in a more peripheral part of the body, such as the wrist or the foot and ankle.
If a nerve root or peripheral nerve is subjected to sustained pressure then the feeling of pins and needles will develop in the skin supplied by that nerve. We are all familiar with this when we sit too long on a hard chair or bench and our foot "goes to sleep". When we get up and start to move again the pins and needles feeling starts in the limb and lasts for several minutes.
Nerve pressure or nerve root irritation will cause pins and needles, or pain, or weakness - and often all three will happen at the same time or within a few days of each other.
Carpal tunnel syndrome is the commonest example of peripheral nerve pressure when the median nerve is compressed as it passes through the carpal tunnel at the wrist. Pins and needles in the thumb and palm is the commonest symptom of carpal tunnel syndrome.
Labels: carpal tunnel syndrome, joint pain, nerve pain shoulder, paresthesia, pins and needles, whiplash
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Shoulder and back pain can be closely related - sometimes one leads to another and sometimes the two share a common source related to nerve entrapment.
The shoulder joint and all of its muscles and soft tissues are derived from the same part of the embryo as the fifth vertebra and nerve of the neck. This means that lower neck pain and shoulder area pain can be directly related.
Sometimes
shoulder pain and back pain between the shoulder blades can also occur. Irritation of the lower segments of the neck will typically send pain down into the area between the shoulder blades - this pain is called referred pain. It is often dull and aching in quality and made worse by movements of the neck. This type of shoulder related back pain often causes trigger points to form in the muscles and these can be felt as acutely tender spots.
Labels: back pain, frozen shoulder, pain control, shoulder and back pain, shoulder blade, shoulder nerve, shoulder pain
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Carpal tunnel syndrome and
frozen shoulder problems often seem to occur in the same patients - sometimes at the same time but sometimes many months apart.
Carpal tunnel syndrome is a problem with irritation of the median nerve - one of the main nerves that runs from the forearm into the hand.
The median nerve runs on the palm of the hand side of the forearm - entering the palm of the hand at almost exactly the mid point of your wrist crease. It supplies power to the muscles of the thumb and sensation to the skin of the thumb and the first three fingers - sometimes also to a bit of the fourth or ring finger too. To get into the hand the nerve has to pass through a tunnel of bones and gristle. This tunnel is called the carpal tunnel - so the problem of nerve entrapment there is called
Carpal Tunnel Syndrome.
The commonest reason for carpal tunnel syndrome to develop is when the median nerve is squeezed in the tunnel. This often happens during pregnancy or in diabetic patients or in those with an under active thyroid gland. Often no cause is found at all - it just seems to start from nowhere and this is called
Idiopathic carpal tunnel syndrome.
Sometimes however, carpal tunnel syndrome can arise as a later consequence of frozen shoulder. The median nerve arises from nerve roots that run in the armpit or axilla - just below the shoulder in other words. This group of nerve roots is called the brachial plexus and a good going frozen shoulder can affect the brachial plexus and thus eventually lead to carpal tunnel syndrome.
Labels: carpal tunnel syndrome, cause of frozen shoulder, diabetes joint pain, nerve pain shoulder, shoulder pain
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Does
manipulation for frozen shoulder work?
Manipulation as a treatment for shoulder pain has been around for a long time. The word manipulation can be applied in several different ways.
When we think of shoulder pain in general then physiotherapists will use mobilisation or hands on type manipulation of the shoulder as a means of improving movement range in the joint and thus reducing the symptoms. Osteopaths or chiropractors will do much the same thing - and you might often find that your neck or back is treated at the same time. Not a bad idea actually since shoulder pain and neck pain or upper back pain often go hand in hand.
Manipulation for frozen shoulder is a slightly different issue however. Historically this has been a technique used when the patient is deeply asleep under a general anesthetic and the procedure is performed in an operating theater.
We know that frozen shoulder creates sticky adhesions inside the joint and we think that its these sticky areas that lead to the loss of movement. Manipulation of the shoulder under general anesthetic is a way of trying to force these adhesions apart - thus releasing the stuck shoulder and improving both pain and movement. This type of
frozen shoulder manipulation seems to work but it's a very powerful - almost brutal technique - and there have been several reports in the past of arm bone fractures and other problems.
More modern (and more gentle) approaches include using keyhole surgery to break up the sticky adhesions.
Labels: cause of frozen shoulder, frozen shoulder manipulation, manipulation of the shoulder, shoulder injury, shoulder pain
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The
rotator cuff is the name given to the group of small muscles that stabilise the shoulder when it is in motion.
These rotator cuff muscles are vulnerable to injury and - if torn or if their tendons become inflamed can cause significant shoulder problems.
Treatment of rotator cuff injury can involve either medication, hands on treatment from a physiotherapist or sports therapist, injections or sometimes surgery.
Labels: rotator cuff, rotator cuff tear
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Shoulder nerve pain is not common but it can arise for a number of reasons. The shoulder joint and all the muscles that surround it get their nerve supply from the same part of the spinal cord that supplies the fifth segment of the neck. This is called the C5 segment of the neck.
Pain from the C5 segment of the neck (or from the shoulder joint and the tissues that surround it) is felt from the top of the arm, down over the outer part of the elbow and towards the hand. This type of shoulder nerve pain is called referred pain.
The shoulder nerve is also called the suprascapular nerve - it runs above the spine of the shoulder blade bone - passing through a little notch - to supply the joint and its muscles.
Some specialist doctors can inject this suprascapular shoulder nerve as a treatment for chronic shoulder pain.
Read more about your
shoulders by following the links on these pages
Labels: nerve pain shoulder, rotator cuff pain, shoulder nerve, shoulder pain
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Shoulder Injuries are a common problem for those doctors who see athletes or sports men and women.
The shoulder is a very mobile joint and a shoulder injury can be sustained during a fall or during a throwing action or a tackle in football in rugby.
The challenge for the doctor or physical therapist is to figure out which part of the shoulder anatomy has been injured? The underlying problem might lie in the shoulder muscles, the tendons that join the muscles to the bone, the bursa or within the joint itself.
Injury to the shoulder can trigger a tear in the joint capsule or in the labrum - the tissue that deepens the socket that the head of the humerus sits in.
Read more about how injury can affect the
shoulder by following the links on these pages
Labels: rotator cuff, rotator cuff pain, shoulder injuries, shoulder injury, shoulder tendonitis, shoulder tendons
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Shoulder tendonitis is the name given to the condition where the tendons of the shoulder muscles become inflamed. The suffix "itis" means inflammation - think of tonsillitis, dermatitis, appendicitis and the likes. A tendon is the gristle that joins muscle flesh onto bone so "tendonitis" is inflammation in a tendon.
Shoulder tendonitis can be treated by physical therapy, by acupuncture, by exercises or stretches or sometimes by injection of a steroid.
Rarely
tendonitis at the shoulder can progress or deteriorate into a rotator cuff tear.
Read more about your
shoulders by following the links on this page
Labels: rotator cuff, rotator cuff pain, shoulder pain, shoulder tendonitis, shoulder tendons
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Shoulder Replacement
Shoulder replacement is the name given to the surgical technique of inserting a new artificial shoulder joint into the body.
Shoulder replacement surgery is becoming more and more common and the success rate is now very good. Even though fewer shoulder joints are replaced compared to hips and knees the procedure is rising in popularity for two reasons. Firstly, arthritis in the shoulder is less common than it is in the lower limb joints - and, secondly, fewer surgeons are trained in shoulder replacement techniques at present. New techiques are changing things fast however and
shoulder replacement operations are getting better and better all the time.
If you need help to deal with pain in your
shoulders then follow the links on these pages.
Labels: shoulder joint replacement surgery, shoulder pain, shoulder replacement, shoulder surgery
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Shoulder Exercises
Shoulder exercises could help you deal better with your shoulder pain problems.
Exercises can help with a variety of shoulder conditions - from rotator cuff tendonitis to frozen shoulder.
If you think you need shoulder exercises for your painful shoulders or your neck and shoulder pain then you have the option of seeking input from a physical therapist or trying to learn the techniques for yourself from a book or a DVD. I would always recommend the former. Trying to learn to do shoulder exercises on your own is very difficult and you are likely to end up doing them wrongly.
Follow the links on these pages for more information about exercises for shoulder pains
Labels: rotator cuff, shoulder exercises, shoulders
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Zocor and Shoulder Pain
Can treatment with the anti-cholesterol drug trigger
shoulder pain. Zocor or simvastatin as it is sometimes known is one of the most commonly used cholesterol medications in the world.
In general terms zocor is a fairly straightforward drug for most of those who take it but it can trigger joint and muscle pains in some people. The pain caused by zocor is usually quite diffuse in nature but I've had several email questions recently from people with
zocor related shoulder pain.
It may be that these people are making heavy use of their shoulder muscles and thus triggering discomfort which is aggravated by zocor. I'm really not sure of the true trigger for the situation.
You should be aware of this however:
Zocor triggers benign low grade joint and muscle pains in maybe around ten percent of those who take it. This includes zocor shoulder pain. These pains are usually transient and easy to cope with.
More rarely, zocor can cause a severe widespread muscle reaction that can lead quite quickly to serious ill health. Your doctor could pick up on this with a simple blood test. If you are concerned then please see your doctor at an early opportunity.
Labels: muscle injury, shoulder pain, zocor
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Artificial Oil for Creaky Joints
The company who make Synvisc - a synovial fluid replacement product - have announced a new approach and a new version of their product.
Genzyme say that they are seeking approval to use a single treatment of Synvisc-One to treat osteoarthritis of the knee for up to six months. Synvisc treatment is currently approved to be given in three separate doses at once weekly intervals. Synvisc-One combines those doses in one treatment. This means that patients will need only one injection and not three as at present.
A number of companies make synovial fluid replacement products.
Synovial fluid is the natural "oil" that we all have in our joints. When osteoarthritis develops the supply of synovial fluid dries up and the joint becomes dry and stiff. The idea behind synvisc and related drugs is to replace the missing synovial fluid and thus to provide lubrication, better movement and pain relief.
At present synvisc and the other related drugs are mostly used for knee osteoarthritis but some doctors are beginning to experiment with their use in other joints.
Labels: arthritis, injections for joint pain, joint pain, synvisc
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Cherry Juice For Gout Pain
We can all learn something new every day! And good doctors are constantly alert to learning from all of their patients. It takes a lot to surprise me after twenty years in medicine but - I hold my hand up - this is a new one!
I had never heard of cherry juice or fresh cherries being used to treat gout or for gout pain relief until I heard it recently from a patient (who had been told it by his pharmacist, who had heard it from a relative etc etc). Anyway - a quick search for the "treatment of gout" on google turned up one (rather ancient -1950) research paper and a whole stream of anecdotal reports about the positive effect of cherries and their juice. It seems that consuming about half a pound of fresh cherrys a day or half a litre of fresh cherry juice can significantly lessen the pain and swelling of gout.
I've never had gout and I hope you haven't either but I can tell you it's one of the most painful conditions known in medicine.
Our blood contains a salt called uric acid. It's there all the time in everyone but is normally fully dissolved in the way that sugar is fully disolved in a hot cup of tea. But ... if the tea cools down ... what happens to the sugar? It comes out of solution as little sharp edged crystals. Well, guess what - that's exactly what happens in an attack of gout pain.
A change in the blood chemistry allows the uric acid to crystalise out of solution and form little jaggy crystals (like bits of broken glass) in the joints. For some reason the first joint of the big toe is the most commonly affected - and the pain when walking is horrific. Quite literally "like walking on broken glass" as many of my patients describe it.
Anyhow - back to those cherries.
My patient swore that taking the cherry juice had made a big impact on his gout pain and had provided rapid gout pain relief. You might want to try this yourself if you have gout or you might want to recommend it to a friend or relative.I'm not clear whether tinned cherries can have the same effect.
The most commonly quoted explanation of the effect is that cherries contain flavonoid compounds that may lower uric acid and reduce inflammation. As I described above, uric acid is the body salt that triggers gout attacks.
I have found nothing published to suggest that taking regular cherry juice lessens the risk of you having an attack in the first place but if you suffer from gout regularly it may be worth a try. Cherry juice, cherry pie, ice cream with cherry sauce? Mmmm - sounds good to me!
Labels: arthritis, foot pain, gout, joint pain
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Joint Pain and Diabetes
It's long been known - and I've written extensively previously about it - that diabetic patients are more prone to frozen shoulder than the rest of the (non-diabetic) population.
A new study has shown however that it may not be only the shoulder that's affected. Indeed - the study seems to indicate that diabetics have increased stiffness in nearly all their joints - even if they are not aware of it and have no pain at the time.
The study compared the mobility of selected joints in diabetic and non-diabetics.
One hundred people comprising of 50 volunteer diabetics and 50 volunteer non-diabetics participated. The range of motion of the shoulder, elbow, wrist, fingers, hip and knee joins were measured.
The study revealed that there was a significant difference between joint mobility in the diabetic and non-diabetic subjects for all the joints measured - except the knee and elbow joints which showed no measurable differences.
There was also a slight but positive correlation between duration of diabetes and frequency of finger deformities.
The researchers concluded that reduced range of motion of some joints especially of the wrist, shoulder and hand could be seen as a complication of diabetes.
Labels: arthritis, cause of frozen shoulder, diabetes joint pain
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Frozen Shoulder - New Scientific Evidence
The
science behind frozen shoulder has always been somewhat mysterious.
Frozen shoulder experts often disagree on whether the problem is truly due to inflammation or not - some say that an auto immune reaction happens in the gristle around the shoulder.
Fibroblasts are cells that control wound healing and tissue repair. Some previous research has blamed overactive fibroblasts in the trigger of frozen shoulder.
A new study has looked at this in more detail. The aim of the study was to take fluid from the shoulder joint of patients with frozen shoulder and to see if this fluid affected fibroblast cells in a laboratory test tube. They also took fluid from patients without frozen shoulder for comparison.
The fluid from frozen shoulders caused a marked increase in the test tube fibroblast activity.
These findings demonstrate that fluid from shoulders with frozen shoulder contains chemicals or growth factors that influence fibroblast activity - and this may well be the basic trigger for the frozen shoulder process.
Labels: cause of frozen shoulder, frozen shoulder, shoulder pain
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Back Pain and Tumour
Back pain due to cancer is very rare - that's the good news - but it does happen and it's very important for both doctors and their patients to be aware of the warning signs.
A
recent article published in the European Spine Journal highlights the most important issues.
The researchers looked at all published studies covering issues related to
back pain and cancer.
Six studies evaluating 22 different clinical features and tests were identified.
Malignant cancer as a cause of back pain is rare - the scientists in this study foun rates between one in a thousand cases and, at most in some groups of patients, three in a hundred.
Features that acted as major warning signs or
red flags for cancer were
- A previous history of cancer
- A high ESR blood test
- A reduced hematocrit blood test
- And overall clinician judgement
A combination of age more than 50 years, a previous history of cancer, unexplained weight loss, and failure to improve after 1 month were highly worrying features.
The authors emphasised that malignancy is rare as a cause of low back pain. The most useful features and tests are a previous history of cancer, elevated ESR, reduced hematocrit, and clinician judgement.
I'll say again here what I've said many, many times before .... if you are concerned about a persistent back ache then go see your doctor. Now please !
Labels: back pain, cancer, joint pain, red flag signs
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Shoulder Pain Talk
I'm always on the look out for new high quality
shoulder pain resources on the internet.
Dr Mike Carroll MD has created an extensive new blog site called
Shoulder Pain Talk - it covers a wide range of different aspects relating to shoulder pain - including
rotator cuff injury and
shoulder replacement surgery.
Many other topics are also covered with up to date research and information explained in clear and easy terms.
Take a look at Mike's site - it's a good complement to the frozen shoulder information available in the Joint Enterprise site.
Labels: rotator cuff pain, shoulder pain, surgery
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A New Way To Treat Frozen Shoulder
Doctors are using synovial fluid replacement products to treat frozen shoulder pain and shoulder arthritis. Several synovial fluid replacement products exist but the commonest one used for shoulder pain is Hyalgan.
Hyalgan is mostly used for knee arthritis in patients who have not responded to simple treatment options.
However, a recent study presented at the American College of Rheumatology Annual Scientific Meeting suggested that Hyalgan may be beneficial for patients with arthritis pain in the shoulder.
More than 600 patients were studied. They suffered from moderate to severe shoulder pain due to arthritis, rotator cuff muscle pain and adhesive capsulitis or frozen shoulder.
The study showed that patients who received three or five weekly injections of Hyalgan over a six-month period had a statistically significant reduction in pain.
The results seem to show that Hyalgan relieves shoulder pain in most patients with osteoarthritis of the shoulder.
Other doctors recently have used hyalgan and other synovial fluid replacement products to treat chronic shoulder pain that has not responded to intraarticular steroid injections.
The synovial fluid replacement products seem to work best for people who have an osteoarthritis element to their shoulder problem,
No one knows how hyalgan actually works inside the joint but recent research suggests that Hyalgan works inside the cartilage cells to block inflammation pathways.
Labels: arthritis, frozen shoulder, shoulder pain, steroid treatment
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New Concerns About Frozen Shoulder
There is now serious concern amongst experts that cases of frozen shoulder are on the increase.
Doctors have different possible explanations for this but surgeons at the Mayo Clinic say that they think frozen shoulder is becoming more common because of the increase in obesity, diabetes, and an aging population.
Frozen shoulder is a condition in which the shoulder capsule contracts or becomes inflamed, causing adhesions and scarring that "freeze" the shoulder. Inactivity after even a minor injury can bring it on, though it usually begins spontaneously.
Symptoms include pain in the shoulder, especially when attempting to raise the arm. When raising an arm straight up, normal range of motion allows the arm to be raised as high as top of the head. A person with severe frozen shoulder can move a straight arm only waist high or lower. Orthopedists say that if patients and doctors understood the risks and symptoms, the disorder could be successfully treated by physical therapy.
Early diagnosis when the condition is still "freezing" is the key. Early therapy lessens the severity and lifespan of the disease.
Currently, about six million people in the U.S. suffer from the condition. About 10 percent to 20 percent of diabetics will have it at one time or another. And women are affected somewhat more often than men.
Shoulder ligaments are normally elastic and tighten when you reach up high. In a frozen shoulder, the joint gets smaller. Ligaments adhere to the shoulder or tighten at its resting position. Movement becomes painful and difficult, or even impossible.
Doctors have also found that a shot of cortisone into the shoulder may prevent a full-blown case of the disease. For severe cases, surgery is required. But for many with advanced frozen shoulder, full range of motion will not be achieved.
Labels: arthritis, frozen shoulder, shoulder pain, steroid treatment
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Sandals and Painful Feet
Sandals and lightweight shoes may be comfortable in summer but in many cases they are bad for your feet and can trigger off quite troublesome foot and heel pain.
The most commom problem is a condition called plantar fasciitis.
Plantar fasciitis is an inflammation along the bottom surface of the foot of a band of tissue that connects from the ball of the foot to the heel. This band of tissue becomes strained and inflamed and causes pain on the sole of the foot near to the heel.
The strain occurs because your foot muscles are stressed trying to keep the shoes on. It's worse in shoes that are flexible, with no support in the midshaft, and in shoes that are perfectly flat, with no heel elevation.
There's good evidence that having a shoe with a slight heel can take some of the strain off the foot.
There are several different ways to treat plantar fasciitis - some specialists recommend foot stretches, some special insoles and some doctors use injections.
But the best advice for summer is to limit the amount of time you spend in flip-flops. Doctors say they're not good for long walks, or for exercise.
Labels: arthritis, foot pain, heel pain, joint pain, muscle injury
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Whiplash Injury Treatment - New Evidence
Whiplash Injury TreatmentHow to treat acute whiplash neck injuryNew research has confirmed what many involved in treating whiplash injury patients already know. If the initial treatment is too intensive or aggressive then recovery can be delayed not quickened. There may be something to be said for going back to an inital period of rest in a neck collar - something doctors, physiotherapists and chiropractors had moved away from recently.
The new research study was published in the May 25 Early View issue and June print issue of the journal Arthritis & Rheumatism.
"Although there are few effective treatments for curing whiplash, a growing body of evidence suggests that the delivery of intensive aggressive health care shortly after the injury may lead to a longer recovery period" said one of the researchers.
The study showed that those who simply attended their family doctor got better quicker than those who had early intensive hands on treatment from a chiropractor or a physiotherapist.
The results add to the body of evidence suggesting that early aggressive treatment of whiplash injuries does not promote faster recovery.
In particular, the combination of chiropractic
and general practitioner care seemed to significantly reduce the rate of recovery
Labels: joint pain, neck pain, pain control, whiplash
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Surgery For Back Pain
Surgery for Back Pain
Should you have an operation for chronic back pain?The majority of those with chronic back pain will get better or find pain relief without surgery but new research shows that an operation may speed recovery for some
The New England Journal of Medicine have published new research to compare surgery with the simple passing of time for people with severe back pain. Those in the study mainly were known to have a slipped or herniated disc or sciatica
A spine specialist in Holland looked at 283 patients who had suffered from sciatica for at least six weeks before the study began. He found that 95 per cent of patients reported recovery after one year, whether or not they had surgery.
But about 40 per cent of the participants assigned to conservative wait-and-see care also opted for surgery, which seemed to relieve symptoms more quickly than would otherwise have been expected.World recognised spine expert: Richard Deyo of the University of Washington in Seattle - said in a journal editorial
"For patients with persistent sciatica, there seems to be a reasonable choice between surgical and nonsurgical treatment, which may be influenced by aversion to surgical risks, the severity of symptoms, and willingness to wait for spontaneous healing,".
Most experts agree that surgery should only be considered an option if the pain has persisted for at least six weeks .
Labels: arthritis, back pain, joint pain, pain control
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Shoulder Blade Pain
Shoulder Blade PainWhat causes a pain in the Shoulder Blade area?Interestingly, but importantly, shoulder blade pain only rarely arises due to a problem with the shoulder blade.
The shoulder blade is also called the scapula. True problems in the region of the scapula are rare and include bone disease such as infection or bone tumour. These causes account for no more than a tiny percentage of shouder blade pain problems.
Nearly every case of shoulder blade pain is due to a problems in the lower part of the neck or in the upper part of the back. This pattern of pain is known as referred pain. Referred pain from the neck is usually felt along the inner side of the shoulder blade - the side nearest the spine in other words.
How to diagnose Shoulder Blade PainYour doctor or therapist will begin the diagnosis of shoulder blade pain with a simple examination. They will examine your shoulder joint, muscles and the nerves of the upper arm. Your cervical spine (or neck) will also be examined - along with your upper back or thoracic spine.
If your shoulder blade pain is arising in the cervical spine then neck movements will trigger it or make it worse.
Your doctor may organise an x-ray of the neck or an MRI scan to confirm the diagnosis of a neck problem although this is not always required.
If your doctor suspects another reason for your shoulder blade pain then you may need blood tests, a chest x-ray or an MRI scan of the chest or thoracic region.
Severe shoulder blade pain of sudden onset can be an indication of serious heart or blood vessel problems. You should seek medical attention immediately if this occurs
How to treat Shoulder Blade PainThe treatment of shoulder blade pain will in part depend on the cause that your doctor or therapist discovers. The commonest cause is related to the neck or cervical spine and treatment is usually best directed at this area.
Neck treatments for shoulder blade pain often result in a quick and full recovery.
Treatment options for shoulder blade pain include:
painkiller or anti-inflammation medication
physical therapy from a physiotherapist, chiropractor or osteopath
manipulation of the neck or thoracic spine
acupuncture
Labels: arthritis, joint pain, shoulder blade, shoulder pain
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Gout Pain - Does Coffee Help Gout Pain?
Can Coffee Drinking Help Gout?
Gout is triggered by high uric acid levels in the blood. Gout is the commonest inflammatory arthritis in adult men and is becoming more common in women.
Scientists have long thought that high intake of coffee and tea can reduce uric acid levels in the blood and thus reduce the risk of a gout attack and a new study published in the June 2007 issue of Arthritis Care & Research seems to support this - for coffee drinkers at least. Even decaffeinated coffee might help if you are a gout pain sufferer.
The researchers found that coffee consumption is associated with lower uric acid levels but this appears to be due to components in coffee other than caffeine.
The results of the research showed that levels of uric acid in the blood significantly decreased with increasing coffee intake, but not with tea intake.
Interestingly, there was an association between decaffeinated coffee consumption and uric acid levels. These findings back up the idea that components of coffee other than caffeine contribute to the observed association between coffee intake and uric acid levels.
The scientists emphasise that they do not really know how the connection between coffee, gout and uric acid works but they believe that the chemicals in coffee are affecting insulin levels and also producing powerful antioxidant chemicals within our body.
Labels: arthritis, caffeine, gout, joint pain
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Shoulder Pain - Treating Rotator Cuff Pain
The rotator cuff are the group of muscles that surround the shoulder and help to keep it stable and strong during movement.
These muscles can often become a source of pain - either due to inflammation or to tearing in the muscle fibres or in the muscle tendons that join the muscles to the bone.
Recovery from rotator cuff pain can be a long process - and you may receive a bewildering range of advice along the way.
Check out this great
Guide to Rotator Cuff Injury - written by tennis pro Brent Abel. It's a comprehensive overview of the nature of the problem and of the available treatments.
Labels: joint pain, muscle injury, shoulder pain
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Shoulder Joint Surgery
Shoulder replacement surgery is not a new option for patients with severe pain due to shoulder arthritis - but there is an intriguing new approach available which seems to be yielding great results.
Surgeons are putting in the new shoulder joint "in reverse"
With the new reverse shoulder prosthesis, the classic ball-and-socket shape of the joint is basically reversed.
The shoulder is made up of a ball and socket joint and a rotator cuff. The ball connects to the arm, the socket connects to the shoulder blade. The rotator cuff is muscle that surrounds the joint and helps lift and rotate the arm. But in patients suffering from a torn rotator cuff or arthritis, this protection is gone and bone painfully scrapes against bone.
Now a new procedure can help.
Instead of the ball being on the arm side, now we see a socket on the arm side, and the ball is actually on the shoulder side, or the socket side. What the reverse prosthesis does it allows us to stabilize the shoulder, normalize the center of rotation, thus improving function and relieving pain.
The surgery takes about 90 minutes and usually leads to a full recovery in around four months.
Surgeons in Europe have been performing RSP, or reverse shoulder procedure surgery, for 15 years with excellent results. Now the FDA has approved the surgery, but it still will take a while for it to catch on across the country.
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Reverse Shoulder Surgery hereLabels: arthritis, pain control, shoulder pain, surgery
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Frozen Shoulder - Taking Steroids by Mouth
A new review of the evidence has been undertaken to assess whether those with frozen shoulder or adhesive capsulitis might benefit from a short course of oral steroid tablets.
The studies tested people who had adhesive capsulitis for about 6 months.
They were given no treatment, fake treatments, steroid injections or oral steroids.
Oral steroids, such as prednisolone or cortisone were given for about 3 to 4 weeks, and sometimes again for another 3 to 4 weeks if people still had pain and stiffness. All people had physiotherapy or an exercise programme while taking the steroids.
Benefits of oral steroids for adhesive capsulitis or frozen shoulderIn people with adhesive capsulitis, at 3 weeks, oral steroids may work more than fake pills:
- 48 out of 100 people who took fake pills said they were better
96 out of 100 people who took steroids said they were better
Oral Steroids may decrease pain and disability more than fake pills - the studies show that pain may decrease by 2.7 more points on a scale of 0 to 10 with steroids
Researchers also found that disability may decrease by 18 more points on a scale of 0 to 100 with steroids and that oral steroid tablets may increase the ability to move the shoulder more than fake pills - shoulder movement increased by 23 degrees
But these benefits did not last as long as 6 weeks so there is not enough evidence to be certain of the results beyond 3 weeks.
Oral steroids may also improve pain earlier and quicker than no treatment at all. But after 5 months there were no benefits of oral steroids over no treatment. There is also not enough evidence to be certain of the results.
Harms of oral steroidsIn people with adhesive capsulitis who have no serious other problems, taking oral steroids for a short time may not cause serious side effects. But there is not enough evidence to be certain. Other research about steroids taken over longer periods of time shows that harms could include high cholesterol and high blood pressure.
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frozen shoulder treatment Labels: frozen shoulder, shoulder pain, steroid treatment
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Psychological Treatments for Back Pain
Psychological treatments such as cognitive behavior therapy, hypnosis, counseling and relaxation can improve pain and quality of life for those who have chronic back pain.
Chronic back pain is very common and sometimes it is hard to treat. Painkillers and surgery may help but, according to a new review, psychological treatments may also be effective.
A team at the VA Connecticut Healthcare System looked at 22 trials done between 1982 and 2003. These included patients who had had back pain for at least three months. In many cases, they had been in pain for several years.
The studies included the use of cognitive behavior therapy, hypnosis, counseling and relaxation. The researchers looked at 12 pain-related outcomes including pain intensity, depression, disability and quality of life.
They concluded that psychological interventions, either alone or as part of a multidisciplinary approach, were superior to other approaches on the whole range of pain-related outcomes. The best results were on back pain intensity. This is surprising, as the psychological approach was originally developed to help people live with their back pain rather than to reduce it.
Psychological treatments also tend to be more cost-effective for back pain than approaches such as surgery or drug treatments
Many back pain sufferers tend to shy away from any mention of psychology or psychological based treatment - but, if you suffer from chronic back pain, you really should give these methods some serious consideration
You can read
more about this here
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Yoga for Chronic Lower Back Pain
People plagued by
chronic lower back pain may find some relief in yoga class, researchers reported.
Their study of 101 adults with
persistent low back pain found that a gentle yoga class seemed to be a better alternative to either general exercise or a self-help book. Though people in the exercise class eventually improved to a similar degree as their yoga-practicing counterparts, yoga class brought quicker results.
It seems possible that yoga's benefits for both the body and mind explain the effects on lower back pain.
The study participants took a slower-moving form of yoga that was designed for people with lower back problems. Vigorous styles of yoga that include more-advanced poses could potentially make chronic back pain worse.
The Group Health Cooperative in Seattle report the findings in the Annals of Internal Medicine this week.
It's estimated that 14 million Americans practice yoga, often as a way to treat chronic aches and pains. But, in the Western medical literature at least, there have been no previous published studies on the effects of yoga on chronic back pain
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more here
